Anadolu Health Center Women's Health Department Coordinator Prof.Dr.Aydın Arıcı answered our questions about vaccination method used in IVF treatment.
What is vaccination?
One of the methods used in the treatment of infertility is the insemination method called 'vaccination'. The primary goal of this treatment is to provide the development of an egg that can cause pregnancy in women by giving the necessary hormone drugs. The second aim is to take the sperms of the man and pass the procedures that make it easier for the egg to fertilize and give it to the woman through the cervix. The success rate with insemination treatment is around 17-18% in each trial.
Is vaccination suitable for everyone?
Vaccination is a method used in cervical mucus problem, inability to have sexual intercourse, mild sperm disorders and unexplained infertility. The woman's eggs are stimulated with hormones and the time of the procedure is determined according to the development of the eggs. After the semen sample taken from the man is subjected to special laboratory procedures, sperm count, quality and motility are increased. The prepared sperm is given to the womb of the woman with the help of a special cannula in the examination position and after the procedure the patient is rested for about half an hour. For this procedure to be successful, the tubes should be open, the number of motile sperm should be at least 5 million / ml and the woman should preferably be younger than 38 years.
How long will the vaccination treatment take?
Vaccination treatment begins with menstruation and lasts about 12-14 days. We see the patient at the onset of menstruation and begin treatment between the three or fifth day of menstruation. In order to monitor the effectiveness of the drugs and egg development, we periodically ultrasound the woman. We continue to administer hormone medications until the egg development in the ovaries reaches the desired level. When the development of the egg is completed, we make a needle called the fracture needle. When it's time to crack, we call the patient's wife and get sperm. We take these sperm in a series of procedures in the laboratory to select the best ones, the ones with the highest probability of pregnancy. In this way, we make the sperms that we have made higher quality, more dense and more mobile, into the uterus with a plastic cannula under normal examination conditions.
What are the chances of achieving pregnancy with this method?
The success rate with insemination is around 17-18% in each trial. In order to evaluate these numbers, normal pregnancy and fertility rates should be known. Often fertility decreases with age. While women in their 20s and 30s have a chance of getting pregnant at a rate of 25-30 percent every month through regular intercourse, this rate drops to 5 percent in the early 40s. Age is the most important factor affecting the success rate in reproductive assisted therapies. Therefore, the success rate of vaccination with 17-18% in each trial is a good rate. However, if several trials have failed, other treatment modalities should be tried.
If vaccination is not successful, which method is used?
If the woman has a problem such as clogging or adhesion in her tubes, an operation to open the adhesions or tubes by laparoscopy and the appropriate laser or scissors is required before vaccination. However, if there is no response from vaccination treatment, it is necessary to switch to tube baby. Of course, if there is a problem such as endometriosis or uterine fibroids, they must be corrected surgically. In advanced male infertility, if the woman's age is advanced or if the woman's tubes are blocked, the best treatment method is IVF.
What is a test tube?
Nowadays, assisted reproductive techniques such as IVF and microinjection provide many infertile double pregnancies. The first aim of this treatment is to provide the necessary hormone drugs, to ensure the development of eggs that can create pregnancy under follow-up in women and to collect these eggs in a process called egg collection process. Following this, the sperm is taken from the male to pass the process to facilitate fertilization of the egg and then to give it to the egg. Generally, after 3 days, the healthiest embryos are selected and an appropriate number of embryos are inserted into the uterus through a thin cannula.
How many embryos do you transfer to the expectant mother?
The number of embryos to be transferred varies according to the age of the expectant mother and the quality of the embryos. In normal practice, this number is limited to “up to three embryos.. In fact, two embryo transfers of good quality are sufficient in women younger than 35 years. However, the obtained embryos may not always be of the first quality. This is due to factors such as maternal age, genetic factors and sperm quality. In older women or in people who have had several unsuccessful IVF trials, these numbers may be exceeded if the physician considers it appropriate.
Why is embryo count important?
Multiple pregnancies are more common than singleton pregnancies due to 3 or 4 embryos. However, pregnancy is reduced when two embryos are given to prevent this. If 3 or 4 of the embryos hold at the same time, 9-11. weeks, ultrasound guided abdomen with a needle to enter the number of live babies is recommended to be reduced to two. Since this procedure has a 5% risk of losing pregnancy, limiting the number of embryos is one of the most important measures. Today, many centers in Europe are working on single embryo transfer.
Why is multiple pregnancy risky?
Multiple pregnancies are common in assisted reproductive treatments. Multiple pregnancy is the most feared complication of these treatments, because multiple pregnancy is one of the most important causes of premature birth. This is particularly common in ovulation stimulation and vaccination treatments. Embryo reduction can be performed to prevent premature births, which may cause serious problems, and the serious problems that multiple pregnancies may cause in mothers and babies. This process reduces the number of embryos in the uterus and increases the chance of surviving babies. Multiple pregnancies (especially triplets or more) carry the risk of high blood pressure and sugar problems in the mother during pregnancy.
Why can't all embryos have pregnancy?
The resulting embryos may not always be of first quality. This is due to reasons such as maternal age, genetic factors and sperm quality. In general, the number of cells contained in the embryo, where the cell size is equal to each other in the first quality of an embryo can be mentioned. In addition, even if the embryo appears normal and of first quality, there is always the possibility of chromosome structure defects. Studies show that half of the embryos are not genetically normal, even in women younger than 35 years. These rates can reach 80% over the age of 40. All these reasons explain why only a small part of the embryos can provide pregnancy.
What is the multiple pregnancy rate in couples under infertility treatment?
Multiple pregnancies are common in assisted reproductive treatments. This is particularly common in ovulation stimulation and vaccination treatments. Multiple pregnancy rates in vaccination treatment are around 35%. However, this number can be reduced to around 25-30% by limiting the number of embryos transferred to in vitro fertilization to 2 or 3. In multiple pregnancies, the main problem is triple and more triple pregnancies and especially they should be tried to reduce them.
How long does it take to treat the test-tube baby?
There are generally two methods of IVF treatment. The short method begins with menstruation and lasts approximately 16-17 days. We see the patient at the onset of menstruation and begin treatment between two or third days of menstruation. In order to monitor the effectiveness of the drugs and egg development, we periodically ultrasound the woman. We continue to administer hormone medications until the egg development in the ovaries reaches the desired level. When the development of the egg is completed, we make a needle called the fracture needle. 34-36 hours later we do egg collection. We transfer the embryos to the uterus 3 days after combining with the sperm of the spouse.
What are the chances of success in a test tube?
Infertility treatment applied to couples, in cases where the first methods tried unsuccessful with in vitro fertilization treatment, especially in women under 35 years of success rate is 60% in each trial. Here, the age of the woman constitutes the decisive factor and 45% in women aged 35-37, 30% in those aged 38-40, and pregnancy rates between 15 and 40% between 40 and 42 years. For women over the age of 42, the success rate drops to 10%.
It is not applied methods of infertility treatment in Turkey?
In Turkey, the most advanced techniques are used in the treatment of infertility. The success rate in Turkey with the most advanced countries in the world in a position to compete height. With these treatments, 90% of infertile couples can have children. The remaining 10%, but the donor egg and donor will be able to have children with the sperm or surrogate method, but with the statutory requirements in our country because of not allowing them these methods are applied in Turkey. Many of our citizens therefore have to go to neighboring countries for these treatments.
Can you tell us the stages of IVF treatment? (You can explain it step by step broadly)
Stages of IVF:
Who is in vitro fertilized?
Couples to apply IVF:
-In conditions where there is advanced sperm disorder.
Professor Dr. Contact Aydin directly
Anadolu Health Center
Women's Health Department Coordinator
He was born in 1954 and received his primary, secondary and high school education in Galatasaray High School between 1961-1973. He graduated from Istanbul Medical Faculty in 1979. After completing her specialty education in Gynecology and Obstetrics for one year in Paris University and one year in Istanbul Medical Faculty, she completed her specialty in 1986 at Columbia University in New York. Between 1990 and 1992, he received training on reproductive sciences and infertility at the University of Texas Parkland Hospital. He has been working at Yale University School of Medicine since 1992. He is currently Professor and Head of the Department of Reproductive Health-Infertility at this University.
Dr. Her professional interests include infertility, hormonal and reproductive disorders, endometriosis, fibroids and endoscopic reproductive surgery in general. He is currently the editor of 6 international professional journals. He also serves on the editorial board of 20 international journals and as a consultant. He has published more than 200 scientific articles in international journals and books.
He is married and has two sons. Arıcı's non-professional interests are history, archeology, travel, gastronomy and painting.